Highlights
- •Patients with AUR require specific strategies for reducing CAUTI risk.
- •An algorithm for AUR management decreased dwell times of IUCs placed for AUR.
- •An algorithm for AUR management increased utilization of medications to treat AUR.
- •Nurse education using multiple methods aids successful implementation.
- •Provided consistent documentation, EMR extracts effectively monitor implementation.
Abstract
Background
This study implemented and evaluated an algorithm protocol for management of indwelling
urinary catheters (IUCs) among patients treated for acute urinary retention (AUR)
in an intensive care unit. The algorithm protocol (1) instituted in and out catheterization
before placing an IUC for retention; (2) encouraged more consistent use of medications
for AUR; and (3) provided for prompt removal of IUCs placed for AUR.
Methods
An uncontrolled pre- and post-test intervention approach was used to assess the impact
of the algorithm on the treatment of AUR. Bivariate and multivariate analyses assessed
data collected using two approaches: (1) electronic extracts from the electronic medical
record (EMR) versus (2) manual chart reviews.
Results
Findings suggest that the intervention decreased indwelling IUC days by 1.93 average
days and increased medication prescription rates. An EMR extract identified fewer
catheters per patient pre-intervention than a manual chart review, but otherwise the
differences observed in the EMR extract and manual chart review were insignificant.
Conclusions
Implications for practitioners and administrators are that the algorithm protocol
may reduce CAUTI risk and – provided consistent EMR documentation – EMR extracts may
represent an efficient and effective approach for monitoring data when spreading the
intervention.
Graphical abstract
Graphical Abstract
Keywords
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© 2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
